1. 2 Presenters Kris Green Supervisor, Family support services Ted Hawley Family Action Council.

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Presenters

Kris GreenSupervisor,

Family support services

Ted HawleyFamily Action Council

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Today’s objective

As a hospital within a hospital: Demonstrate successful

strategies to overcome the reluctance of ancillary service areas.

Suggest strategies to increase family-centered care practices in a forbidden zone

Share successes gained and challenges still ahead.

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Key Elements of FCC process

The family is the constant in the child’s life

Information exchange is unbiased Recognize and respects different methods

of coping Encourages and facilitates family to

family support Found not only in program or at the

bedside, but incorporates POLICY

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Family Centered Care Principles

The family is the constant in the child’s life

Information exchange is unbiased Recognize and respects different methods

of coping Encourages and facilitates family to

family support Found not only in program or at the

bedside, but incorporates POLICY

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Remote Alaska . . . .

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Alaska’s Geographic & Diversity Challenges (scale)

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Hospital within Hospital:Providence Alaska Medical Center

360 Bed Campus 99-107 Beds are the Children’s

Hospital and Women’s Center - 26 bed pediatric center- 37 licensed bed NICU (45+)- 32 post-partum- 7 LDR

Outpatient subspecialty clinics

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Lofty goals: Bringing change to an 75 yr. old hospital

The journey of many steps, is worth the reward

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Family Action Council Initiative

Involve parent and family in the care delivery of the surgery center (FAC goal in 2003/4)

Build a foundation of family-support services to house FCC initiatives

Use the nationally recognized discipline of child life to create a voice for both the child and family

Impact the design and program delivery, reducing both the patient and family’s fear of the surgery process

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Family Support ServicesPurpose

Compassionately provide therapeutic family-centered care

by collaborating to support those in need as they

navigate the healthcare system.

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FCC and surgery center goals

To improve the care delivery by including parents and families in

decision making, bringing families back to recover room or allowing

families to stay with their child until they were asleep

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Selling the idea

Seized the opening: medication error in child for post-op pain

Used JCAHO standards and recommendations

Research other hospital and use physician to physician examples

Got CMN funding for .5 position

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Family support services

2007 IniativesCommunications materialIntegrate FCC priniciples

Palliative Care

Family Action Council

VolunteersKuddle KorpPeds center

Parents For Parents

CMNfundraising

grantsdonations

4. ED / NICU

CL PracticumCL internships

1. Pediatrics2. Out patient services

3. Surgery Cntr

Child Life3 fte positions

Adult EducParenting Classes

student teachersaides

Hospital based Ed1.6 fte position

Parents for ParentsNICU volunteers

parent navigatorNICU

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D/C life support community based PAMCcommittee

Unit based interventionpeds ctr, L/D, NICUED and day surgery

Bereavement CounDina Banez, chair

Life on Lily pad

MBU outreach.5 ftePPD

Cmty, NICU, Prenatal

Volunteer SupportUnit support

Donation support

Security StaffHospitality Services

SupervisorFamily Support Services

Kris Green

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Change Team

WHO:

• Child Life Specialists

• Parents and patients

• RN’s

• Anesthesiologists

• Physicians and Surgeons

• Technicians.

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Standards and goals

Timely reunification of parent and child, valuing parents presence

Pre-surgery physician of child life medical play and surgery preparation

Assisting families with special considerations

Scheduling and comfort Parents having the option to be with

their child should be a viable choice

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Reaching the goal….

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Change Team

WHEN

1 Year ago:Meet with managers to discuss needs

Funding and selling services

Family Focus

Job description and guidelines

Individually meet with MD’s

Data gathering

Beginning stages of patient interaction

Developing information cards

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Change Team

WHEN

6 months ago:Tours with medical play explanations and visits to both surgery center and pediatrics

Agree to guidelines for parent presence in PACU

Education for staff in all areas

Communication with all disciplines

Design of new area and where families will be incorporated

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Change Team

WHEN

1 month ago:

Calling families from out of town

Distraction toys

Communication

Future planning

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Challenges

• Time & Communication

• Work load

• Mindset

• Protocol

• Until proven it doesn’t work

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Successful strategies• Talk with management and a representative from

each area

• Discuss and listen and incorporate concerns into solutions

• Set clear boundaries and expectations

• Make staff job’s easier

• Giveaways that promote your mission

• Sit in the backseat first, then take the wheel

• Take time to breathe, then react

• Know that change is hard and you are the element of change for them

• Document!!!

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Keeping momentum going

Keep statistics, advertise success, and publicly praise collaboration

Keep advocating for what is best for patients and families

Reciprocate your allies Keep committees connected Go on vacation… then they know how

much you really do!

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The start…..

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With Child life’s influence……

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What’s working

Pre-arranged tours

Support to staff

Distraction& environment

Staff tolerance

Parents’ perceptions

Anesthesia & Surgeons

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Care delivery using .5 position of Child life staff

Annual pediatric “day surgeries” : 1200

Annual pediatric surgery center: 500

Patient’s Served January 2007-June30, 2007

63%

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Future plans

Survey for children to complete

DVD/Web Video

Benefited FT position

Coloring books and distraction tools

Pediatric trained anesthesiologists

Protocols for IV starts

Induction room with parent’s present during induction

Improved pediatric pain assessment skills and tools

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The Children’s Hospital at Providence

3200 Providence Drive • POB 196602

Anchorage, AK 99519

Kris Green 907-261-5895 (Phone)

[email protected]